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Prototype for opiates
What is the physiology of pain?
- Injury > Arachidonic Acid >Cyclooxygenase > prostaglandins (Vasodilation) > Activating Pain receptors
- Injury > Bradykinin (Vasodilation) > Activating Pain Receptors
What is exogenous pain relief
Things we take in to relieve pain
What is endogenous pain relief
- System of opioid peptides: endorphins, seratonin, GABA
- Things our body can do to relieve pain
What are the two types of pain we look for?
- Duration:Acute, Chronic
- Origin: Somatic
What to look for during pain assessment
- relation to time, activity
- pain scale
What are the 3 categories of pain management?
- Non-Opiates: Acetaminophen, Salicylates, NSAIDs
- Adjuvant: Benzodiazepine, TCA, Corticosteroids
What is the therapeutic effect of opiates?
interferes with pain impulses thereby decreasing pain
What are the ADE of Opiates?
- Depresses CNS: decreases respiratory rate, sedation, dizziness
- Depress GI Tract: N/V, Constipation
- Alters psychological response to pain
- produces Euphoria
What are the route of administration for Opiates?
- PCA (Patient Controlled Analgesia)
What is common clinical use for opiates?
- Severe-Moderate pain relief
- acute pulmonary edema
- severe non-productive cough (CODEINE, ANTITUSSIVE)
What's an antitussive?
cough suppressant (codeine)
When do you use opiates cautiously?
- pt has respiratory depression
- Chronic lung disease
- kidney or liver failure
- increased intracranial pressure
What are infrequent uses for opiates?
- invasive diagnostic test
- pre-op sedation
- labor and delivery
What is an opiate antagonist?
- Naloxone (Narcan)
- counteracts opiates by binding to opiate receptors
- *Not a CNS stimulant*
What is important for a drug user when administering an opiate antagonist?
monitor for withdrawal symptoms
When is it considered opiate abuse?
When it is being used for mind-altering
What are some symptoms of opiate abuse?
- decreased CNS
- nodding head
- myosis (constricted pupils)
- slurred speech
- decreased HR
- decreased Resp
What are treatments for opiate abusers?
- Bupienorphine (suboxone)
will still be addicted, but will be more productive